Sample CQ For Website

BIG PHARMACEUTICALS, INC.
Protocol No.: SAMPLE

Date: November 21, 2006
System Name: CIP / SIP Control System
Building/Area: Building 88
Room: Powerhouse
CONTROLLER QUALIFICATION
CONTROLLER QUALIFICATION PROTOCOL FOR

CIP / SIP CONTROL SYSTEM
The attached protocol has been approved for
format/content and is acceptable for execution.
Prepared By:
The attached protocol has been completed, the

results reviewed and found to be acceptable.
Date:
I.Q. Corporation
Format Approval
Content Approval
ENGINEERING:
ENGINEERING:
SIGNATURE
SIGNATURE
P. PIPER
Date:
P. PIPER
PRINT
PRINT
QUALITY ASSURANCE:
QUALITY ASSURANCE:
SIGNATURE
SIGNATURE
D. NAMED
Date:
D. NAMED
PRINT
PRINT
PRODUCTION:
PRODUCTION:
SIGNATURE
SIGNATURE
D. NAMED
Date:
D. NAMED
PRINT
PRINT
REGULATORY:
REGULATORY:
SIGNATURE
SIGNATURE
S. NAMED
PRINT
SAMPLE
Date:
S. NAMED
Date:
Date:
Date:
Date:
PRINT
Page 1 of 211

Room: Powerhouse
TABLE OF CONTENTS
1.0
Purpose
2.0
Scope
3.0
Responsibilities
4.0
References
5.0
System/Equipment Description
6.0
Rationale
7.0
Procedure
8.0
7.1
Controller Qualification
7.2
Acceptance Criteria
Abbreviations
SAMPLE
Page 2 of 211

Room: Powerhouse
1.0
PURPOSE
The purpose of this Controller Qualification (CQ) Protocol is to verify that the CIP/SIP
Control System is installed in accordance with design specifications, manufacturer's
recommendations, and applicable vendor/engineering drawings.
2.0
SCOPE
This Controller Qualification Protocol will be performed on the CIP/SIP Control
System, located in Building 88.
3.0
4.0
RESPONSIBILITIES
3.1
The Validation Department has overall responsibility for the execution

of the Validation Program and scheduling of the validation activities.
3.2
The Maintenance/Engineering Manufacturing and QA Validation

Departments are responsible for provisions of all applicable standard
operating procedures (SOPs).
3.3
The Manufacturing/Maintenance Department has responsibility for

providing the required operators, materials and test equipment for the
operation and validation of the system.
3.4
The Validation Committee is responsible for the review of the

Qualification Protocol for format, content and acceptability approval for
execution.
REFERENCES
4.1
SAMPLE
Engineering, validation and manufacturer's documents and drawings used to

develop and execute the Controller Qualification Protocol are listed on the
following forms:
4.1.1
Drawings
4.1.2
Manuals
4.1.3
Specifications
4.1.4
Procedures
Page 3 of 211

Room: Powerhouse
5.0
SYSTEM/EQUIPMENT DESCRIPTION
This protocol addresses the Big Pharma CIP/SIP Control System for Building 88. The
primary function of the CIP/SIP Control System is to perform the sequencing required
to clean the different process piping and equipment in the Big Pharma 88 building.
The correct sequencing is verified through the use of feedback limit switches on each
value and device. CIP/SIP process data is printed on Kaye Digistrip recorders located
in each process area. The process data is directly transmitted, as an analog signal,
from each instrument to each kaye channel.
5.1
The control system contains three primary hardware subsystems:

A.
PLC Subsystem
B.
Main Operator Control Station
C.
Remote Operator Control Station
5.1.1
SAMPLE
The PLC Subsystem contains the primary processing power for the
entire system. The other subsystems communicate directly to the PLC
Subsystem but cannot operate without it. The PLC Subsystem is
directly responsible for the execution of all CIP/SIP logic The
components of the PLC Subsystems are as follows:
A.
PLC 5/40 Programmable logic controller located in panel CP-01

on the Powerhouse.
B.
Action Instruments control coprocessor. This industrial 386 PC

handles communication with the Nematron Remote Operator
Control Stations and the Thornton Instrument Network. It is
located in panel CP-01 on the Powerhouse.
C.
Instrumentation:
The majority of the input sensors are
Thornton instruments.
They measure flow, conductivity,
temperature and levels. The Thornton 770 PCs are devices
which can process four different measurements simultaneously.
Each of the 770 PCs transmitters is connected to a two wire
local area network (LAN) called T-NET.
There are two
separate T-NETS within the plant. The instrument readings are
digitized and transmitted over these T-NETs to the control
coprocessor. The data is then written to the PLC as scaled,
floating point values. The few inputs that are not from the
Thornton network are wired directly to the PLCs analog input
modules.
These instrumentation devices are located
throughout the plant.
Page 4 of 211

Room: Powerhouse
D.
An I/O Subsystem including:

1.
Allen Bradley Digital Input/Output Modules
2.
Allen Bradley Analog Input/Output Modules
3.
SMC Solenoid Valve Banks: These are outputs on the

Allen Bradley remote I/O network.
These devices are located throughout the plant.

E.
CIP Batch Printer:

A single, serial, dot matrix, printer is
connected to both the Main Operator Control Station and the
Control Coprocessor. It records CIP events as they occur. It is
located in panel CP-22 on the Powerhouse.
5.1.2
The Main Operator Control Station Subsystem is located in CP-01 on

the Powerhouse. It consists of an Allen Bradley Panelview, model
2711-KCI. This station is primarily for giving the operator an overall
look at the system status. Graphic displays provide information on the
status of devices being used by the system. No CIP devices can be
controlled from this station. It is for monitoring only.
5.1.3
The Remote Operator Control Station Subsystem consists of four

Nematron 120 industrial terminals. There is one located in:
A.
Suite 100
B.
Suite 200
C.
Suite 300
D.
Suite 400
The Remote Operator Control Stations are the primary interface

between the operator and the central system. It is from these
consoles that automated cleaning sequences are selected and started.
The Remote Operator Control Stations also provide information about
the progress of a cleaning sequence.
SAMPLE
Page 5 of 211

Room: Powerhouse
6.0
RATIONALE
Where appropriate, testing will be conducted at the field devices and at the PLC to
insure proper system functioning. Testing should not be conducted at field devices
when equipment or personnel safety could be compromised.
7.0
PROCEDURE
7.1
SAMPLE
7.1.1
The specific requirements for the Controller Qualification are provided

on the following forms entitled Controller Qualification. These data
forms have been developed to provide completeness, consistency and
accuracy of data collection and inspection required.
7.1.2
The primary purpose of the Controller Qualification is to run the process

equipment and control systems through its paces and carefully test and
document related activities. Document operational inspections and test
results with black, indelible ink, ball-point pen on the forms incorporated
or attached to this protocol. Unless instructed by the protocol, test and
operational steps may be performed out of sequence.
7.1.3
Testing performed by a third party approved by Big Pharma is

acceptable. The results shall be affixed to the appropriate attachment
as directed by the protocol.
7.1.4
Proper completion and review of the Controller Qualification forms by a

second, independent validation person will constitute completion of the
Controller Qualification activity.
7.1.5
CONTROLLER QUALIFICATION TEST METHODOLOGY: The installation

data sheets will contain but not be limited to the following document forms:
A.
Controller Qualification Prerequisites
B.
Purchase Order Inspection
C.
Programmable Logic Controller Verification
D.
Ancillary System Specification Verification
E.
Hardware Configuration Verification -Jumpers
F.
Input/Output List and Points Verification
G.
Major Hardware Component Verification
Page 6 of 211

Room: Powerhouse
SAMPLE
H.
Utilities - Electrical
I.
Supply Voltage and Circuit Protection Verification
J.
Software Component Verification
K.
Software Application Code Verification
L.
Security Code Test
M.
Functional Test Verification
N.
Alarm Verification
O.
Power Failure Test
P.
Environmental Operating Parameters Verification
Q.
Test Equipment
R.
Drawings
S.
Spare Parts List
T.
Manuals
U.
Standard Operating Procedures
V.
Amendment(s) and Deviation(s)
W.
Summary and Conclusions
Page 7 of 211

Room: Powerhouse
7.2
ACCEPTANCE CRITERIA
The Acceptance Criteria are the specific set of standards or design
specifications that each piece of equipment or system must meet in order to
demonstrate a high level of confidence that the system/equipment is capable of
consistently operating within established limits or tolerances.
Acceptance Criteria for Controller Qualification (CQ) may include, but is not
limited to, the follow ing requirements:
Instrumentation:
Verification that the controllers and components are appropriately identified

and installed according to manufacturers specifications.
Verification that all configurable switches and jumpers are documented for
baseline information.
Verification that wiring of the control system hardware components to the
field devices have been properly identified and functional per specified
drawings.
Verification that the input and outputs modules are properly installed per
specified drawings.
Verification that the ancillary control system(s) and association components
have been properly installed and identified per specified drawings.
Utilities:
Verification that the supplied utilities meet the vendors specified

requirements.
Verification that the individual system components are supplied with utilities
that meet the vendors specified requirements.
Verification that the circuit protection devices are installed and identified per
specified drawings.
Security:
Verification that the program security functions as specified by the vendor.
Softw are:
SAMPLE
Verification that the application software is the specified revision and that
any subsequent changes made are supported by Change Control SOP 214.
Page 8 of 211

Room: Powerhouse
Verification that the application code currently operating in the controller is

in a controlled and secured file location in both hard copy and computer disk
form.
Verification that the application code is properly annotated and all input and
output software variables have a unique point descriptor assigned to the
point.
Draw ings and Manuals:
Verification that current drawings and applicable manuals, such as vendor

installation, operation and maintenance manuals, are properly documented
and are accessible to the appropriate personnel.
Functional:
Verification that the control system operates as designed and in accordance

with the application software and applicable manufacturers specifications.
Alarm and Interlocks:
Verification that all field device alarms and interlocks are properly identified,
function as specified, and where applicable the appropriate response is
observed.
Pow er Failure:
Verification that the CPU and operator interface modules do not experience
a failure due to the removal of power.
Verification that during the Power Failure test, all devices default to a failsafe mode.
Verification that when power is restored, the CPU restarts the program
safely, or returns to an initial condition from which the operator can restart
the operation, and the operator interface panel recovers from the power
failure and is fully functional.
Environment:
SAMPLE
Verification that the environmental conditions for the control system

components are documented and that the temperature and relative humidity
are within the manufacturer's specification.
Page 9 of 211

Room: Powerhouse
8.0
ABBREVIATIONS
A
AC
A/C
amp
atm
Ampere
Air conditioning
Alternating Current
Ampere, also A
Atmosphere
mg
mHz
MHz
mm
mmHg
BTU
C
cfm
British Thermal Units

Degree Celsius
Cubic feet per minute
kVA
cGMP
NIST
cfu
Current Good Manufacturing

Practices
Colony forming unit
CQ
DPU
Controller Qualification
Distributed process units
OD
ohm/
e.g.,
F
ft./min.
For example; such as

Degree Fahrenheit
Feet per minute
OK
OQ
P&ID
GMP
gph
gpm
HEPA
Good Manufacturing Practices

Gallons per hour
Gallons per minute
High efficiency particulate air
PH
psf
psi
psig
hp
hr.
Hz
Horsepower
Hour
Hertz
RH
rpm
RTD
i.e.,
in
That is
Inch
s
SOP
IQ
Installation Qualification
k
kg
kV
kW
kWh
l
Kilo
Kilogram
Kilovolt
Kilowatt
Kilowatt-hour
Liter
sq. ft. or
SF
SS
g
V
W
w.c.
lb
m
mb
mfg.
Pound (avoirdupois)
Meter or milli
Millibar
Manufacturing
WIF
WFI
W.G.
w.g.
SAMPLE
NBS
N.V.
Milligram
Millihertz
Megahertz
Millimeter
Conventional millimeter of
mercury
Kilovolt ampere
National Bureau of
Standards
National Institute of
Standards & Technology
Not Visible - requires
disassembly
Outside diameter
The SI unit of electrical
resistance
Okay
Operational Qualification
Piping and Instrumentation
Diagram
Phase (3 PH)
Pounds per square foot
Pounds per square inch
Pounds per square inch,
gauge
Relative humidity
Revolutions per minute
Resistance temperature
detection
Second
Standard Operating
Procedures
Square feet or foot
Stainless steel
Micro
Microgram
Volt (240 V)
Watt
Water closet (Arch.) Or
water column (Mech.)
Weld Inspection Form
Water for Injection
Wire gage
Water gauge
Page 10 of 211

Room: Powerhouse
CONTROLLER QUALIFICATION PREREQUISITES
Before execution of Controller Qualification (CQ) Activities, the following prerequisites must be
addressed and found acceptable and approved by Big Pharma.
Prerequisites
Verified By / Date
System has been transferred from construction and startup is completed.

Construction Punch List and/or deviations documents
have been checked and approved by Big Pharma for
continuation in system completion.
Software specifications relative to the Controller System
of the machine are available.
Instrument Index has been reviewed and updated to
reflect current purchased/existing instruments
Current revisions to reference documents and/or drawing
have been verified.
Reference documents and/or drawings are available, or
assignment to procure them has been documented on
System Punch List.
Prerequisites are completed and reviewed prior to
execution of Controller Qualification.
______________________________________The Protocol Executor

SIGNATURE/DATE
______________________________________Big Pharma
SIGNATURE/DATE
SAMPLE
Page 11 of 211

Room: Powerhouse
PURCHASE ORDER INSPECTION
Verify that the specified component is supplied and installed in accordance with specifications and
options indicated by their respective purchase orders. If a purchase order is not available, refer to
applicable drawings such as engineering drawings.
Equipment Name:
Manufacturer:
Equipment ID No.:
Model No.:
Serial No.:
Verified By:
Location:
Purchase Order:
Equipment Status (CIRCLE ONE):
Verified By:
New
Transferred/Used
Location of Purchase Order:

Equipment Supplied and
Installed per Purchase Order:
(Yes / No):
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 12 of 211

Room: Powerhouse
PROGRAMMABLE LOGIC CONTROLLER VERIFICATION
Controller Tag ID No.: PLC CIP
Controller Description: Allen Bradley PLC-5 Programmable Logic Controller
Verify the following information about the controller to ensure that it is installed in accordance with
design specification.
Installation Verification Items
Specified
Actual
Manufacturer
Allen-Bradley
Model No.
PLC 5/40
Serial No.
Not Specified
Location
CP-01
NEMA Rating
Not Specified
UL Rated (Yes / No)
Yes (UL listed CSA Approved)
Number of Inputs Connected
459 used out of 504 available
Number of Outputs Connected
91 used out of 124 available
Processor Unit, Slot 0 / Cat. No.
1785-L40B 1
Rack 0, Group 0
Spare slot
Rack 0, Group 1
Spare slot
Rack 0, Group 2
Spare slot
Rack 0, Group 3
Spare slot
Rack 0, Group 4
Spare slot
Rack 0, Group 5
Spare slot
Reference Documents Name and No.:
IQC Dwg ESO493-05.B07

Sheet 3 of 23
Enhanced Ethernet PLC5
Programmable controllers users
manual (AB #1785-6.5-12)
COMMENTS:
1
Contains the capacity for 48K of programming instructions.
CP-01 is on Powerhouse.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 13 of 211

Room: Powerhouse
PROGRAMMABLE LOGIC CONTROLLER VERIFICATION (CONTD)
Specified
Actual
Rack 0, Group 6
Spare slot
Rack 0, Group 7
Spare slot
Rack 1, Group 0
Spare slot
Rack 1, Group 1
Spare slot
Rack 1, Group 2
Spare slot
Rack 1, Group 3
Spare slot
Rack 1, Group 4: Analog Output Module
4 Analog Output Module

Model 1771-OFE2
Model 1771-OFE2
Model 1771-OFE2
8 Analog Input Module
Model 1771-IFE
IQC Dwg No. ES0493-05.B7
Sheet 3 of 23
1771-IFE Analog Input Users
Manual (AB #1771-6.5.90)
1771-OFE Analog Output Users
Manual (AB #1771-6.5.30)

Rack 1, Group 7: Analog Input Module
COMMENTS:
1
These modules are located in CP-01 on Powerhouse.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 14 of 211

Room: Powerhouse
Specified
Actual
Rack 2, Group 0: 16 Digital Input Module
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
Rack 2, Group 6
Spare slot
Rack 2, Group 7
Spare slot

Sheet 4 of 23
1771-IBD 10-30VDC Input
Module Installation Book
(AB #1771-2.75)
1771-OBD 10-30VDC Output
(AB #1771-2.76)
COMMENTS:
1
These modules are located in CP-01 on Powerhouse.
This chassis also contains a remote I/O adapter, model 1771-ASB, in the leftmost slot.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 15 of 211

Room: Powerhouse
Specified
Actual
Rack 3, Group 0: 16 Digital Output Module
1771-OBD
1771-OBD
Rack 3, Group 2
Spare slot
Rack 3, Group 3
Spare slot
Rack 3, Group 4
Spare slot
Rack 3, Group 5
Spare slot
Rack 3, Group 6
Spare slot
Rack 3, Group 7
Spare slot

Sheet 4 of 23
1771-OBD 10-30VDC Input
(AB #1771-2.76)
1771-ASB Users Manual
(AB #1771-2.48)
COMMENTS:
1
These modules are located in CP-01 Powerhouse.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 16 of 211

Room: Powerhouse
Specified
Actual
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
IQC Dwg No. ES0493-05.C37

Sheet 3 of 44
(AB #1771-2.75)
(AB #1771-2.76)
1771-ASB Users Manual
(AB #1771-2.48)
COMMENTS:
1
This chassis also contains remote I/O adapter module in the left most slot. Model #1771-ASB
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 17 of 211

Room: Powerhouse
Specified
Actual
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-OBD
1771-OBD
Rack 5, Group 6
Spare slot
Rack 5, Group 7: 8 Analog Input Module
1771-IFE

Sheet 3 of 44
(AB #1771-2.75)
(AB #1771-2.76)
Manual (AB #1771-6.5.90)
COMMENTS:
1
These modules are located in Panel CP-01A,
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 18 of 211

Room: Powerhouse
Specified
Actual
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD
1771-IBD

Sheet 4 of 44
(AB #1771-2.75)
COMMENTS:
1
These modules are located in Panel CP-01A, Mechanical Room
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 19 of 211

Room: Powerhouse
Specified
1771-IBD
1771-OBD
1771-OBD
Rack 7, Group 3
Spare Slot
Rack 7, Group 4
Spare Slot
Rack 7, Group 5
Spare Slot
Rack 7, Group 6
Spare Slot
Rack 7, Group 7: 8 Analog Input Module
1771-IFE

Sheet 4 of 44
(AB #1771-2.75)
(AB #1771-2.76)
Manual (AB #1771-6.5.90)
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 20 of 211

Room: Powerhouse
Specified
1771-IBD
1771-IBD
1771-OBD
1771-IBD
Rack 10, Group 4
Spare Slot
Rack 10, Group 5
Spare Slot
Rack 10, Group 6
Spare Slot
Rack 10, Group 7
Spare Slot

Sheet 5 of 44
(AB #1771-2.75)
(AB #1771-2.76)
Actual
COMMENTS:
1
2
3

NOTE - Because Allen Bradley uses octal numbering, racks 8 and 9 do not exist.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 21 of 211

Room: Powerhouse
Specified
Actual
Rack 11, Group 0
Spare Slot
Rack 11, Group 1
Spare Slot
Rack 11, Group 2
Spare Slot
Rack 11, Group 3
Spare Slot
Rack 11, Group 4
Spare Slot
Rack 11, Group 5
Spare Slot
Rack 11, Group 6
Spare Slot
Rack 11, Group 7
Spare Slot

Sheet 5 of 44
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 22 of 211

Room: Powerhouse
ANCILLARY CONTROL SYSTEM SPECIFICATION VERIFICATION
Verify the controller contact ancillary system(s), and components, such as, controls, monitors,
processors, I/O modules, recorders, etc., are installed in accordance with applicable
documents.
Designated
Actual
System Type:
Operator Terminal
Manufacturer:
Allen-Bradley
ID No.:
Main OCS
Model No.:
Panelview 1200, 2711-KC1
Serial No.:
IMOGN95SK
Location:
CP-01 Powerhouse
NEMA Rating:
NEMA type 4
UL Rated: (Yes / No)
Yes
Firmware Version:
5.0
Reference Documents:
See below
COMMENTS:
1
Planelview operator terminals users manual (AB#2711-812).
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 23 of 211

Room: Powerhouse
ANCILLARY SYSTEM SPECIFICATION VERIFICATION
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
Controller Tag ID No.:
CP-02
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-02
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:
Nematron series 110/120

installation and terminal guide
Doc. IWS-232.
COMMENTS:
1
This unit is configured as an RS-232 industrial terminal.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 24 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
CP-03
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-03
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:

Doc. IWS-232.
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 25 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
CP-04
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-04 Suite 100
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:

Doc. IWS-232.
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 26 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
CP-05
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-05 Suite 200
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:

Doc. IWS-232.
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 27 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
CP-TT-07
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-TT-07 Suite 300
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:

Doc. IWS-232.
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 28 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Operator Terminal
Manufacturer:
Nematron
CP-07
Model No.:
IWS-120
Serial No.:
Not Specified
Location:
CP-07 Suite 400
NEMA Rating:
NEMA 4X
Yes
Firmware Version:
2.00
Unit Rev:

Doc. IWS-232.
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 29 of 211

Room: Powerhouse
documents.
Specified
System Type:
Industrial Computer
Manufacturer:
Action Instruments
Not Specified
Model No.:
CMPC-5BOXPC
Serial No.:
A316J
Location:
CP-01 Powerhouse
NEMA Rating:
Not Specified
Yes
Actual
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 30 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Microprocessor Recorder
Manufacturer:
Kaye
CP-02
Model No.:
Digistrip 4S Plus
Serial No.:
Not Specified
Location:
NEMA Rating:
Not Specified
Not Specified
Firmware Version
Not Specified
Kaye Digi 4S Plus users guide
COMMENTS:
1
This recorder is used to monitor both CIP/SIP parameters and process parameters.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 31 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Kaye
CP-05
Model No.:
Digistrip 4S Plus
Serial No.:
Not Specified
Location:
Suite 200
NEMA Rating:
Not Specified
Not Specified
Firmware Version
Not Specified
COMMENTS:
1
This recorder is used to monitor both CIP/SIP parameters and process parameters.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 32 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Kaye

Model No.:
Digistrip 4S Plus
Serial No.:
Not Specified
Location:
Suite 300
NEMA Rating:
Not Specified
Not Specified
Firmware Version
Not Specified
COMMENTS:
1
This recorder is used to monitor both CIP/SIP parameters and dispatch parameters.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 33 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Kaye
CP-40
Model No.:
Digistrip 4S Plus
Serial No.:
Not Specified
Location:
Suite 400
NEMA Rating:
Not Specified
Not Specified
Firmware Version
Not Specified
COMMENTS:
1
This recorder is used to monitor CIP/SIP and Lyo parameters.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 34 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Kaye
CP-22
Model No.:
Digistrip 4S Plus
Serial No.:
Not Specified
Location:
Powerhouse
NEMA Rating:
Not Specified
Not Specified
Firmware Version
Not Specified
COMMENTS:
1
This recorder is used to monitor only CIP/SIP parameters.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 35 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 10, Group 0
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-04
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device is connected to the CIP PLC 5/40 via a remote I/O link. The device is directly addressed as
0:100/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 36 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 12, Group 0
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-08,
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:120/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 37 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 12, Group 2
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-08, Area
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:122/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 38 of 211

Room: Powerhouse
documents..
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 12, Group 4
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-09
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:124/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 39 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 12, Group 6
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-10, Powerhouse
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:126/0-15
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 40 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 14, Group 0
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-01
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:140/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 41 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 14, Group 2
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-01
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:142/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 42 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 14, Group 4
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-02
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:144/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 43 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 14, Group 6
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-02
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:146/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 44 of 211

Room: Powerhouse
documents..
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 15, Group 0
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-03
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:150/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 45 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 16, Group 0
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-05
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:160/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 46 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 16, Group 2
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-05
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:162/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 47 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 16, Group 4
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-06
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:164/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 48 of 211

Room: Powerhouse
documents.
Specified
System Type:
Solenoid Bank
Manufacturer:
SMC
Rack 16, Group 6
Model No.:
IN313-AB1
Serial No.:
Not Specified
Location:
CP-S-07
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
0:166/0-15.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 49 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Instrument Network Transceiver
Manufacturer:
Thornton
Gateway 1, T-NET-2
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified
770 Network Interface

Instruction Manual
COMMENTS:
1
Environmental operating specification: 32-122 F
Relative humidity specifications: 0-95% Non condensing
This has an RS-232 Interface and a amp fuse circuit protection located on the back plane of the
printed circuit board.
The Thornton instrument network address for this device is 2:128
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 50 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Process Controller / Temperature

Meter
Manufacturer:
Thornton
TT-035/036
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified
770 PC Process Controller

Instruction Manual PP.57-58
COMMENTS:
1
Environmental operating specification: 32-122 F.
Relative humidity specifications: 0-95% Non condensing.
It has four individual software controlled set-points which can be set as a high or low limit. Any set-point
can be programmed to operate one of two output relays.
5
The Thornton instrument network address for this device is 2:56.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 51 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

Meter
Manufacturer:
Thornton
TT-034/044
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
can be programmed to operate one of two output relays.
5
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 52 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Process Controller /
Conductivity / Flow Meter
Manufacturer:
Thornton
CIT-038 / TT-040 / FT-039
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
can be programmed to operate one of two output relays. It has temperature compensation with automatic
reference to 25 C conductivity.
5
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 53 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-041 / TT-043 / FT-042
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
5
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 54 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Conductivity Meter
Manufacturer:
Thornton
CIT-048 / TT-047
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
5
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 55 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

Meter
Manufacturer:
Thornton
TT-045/046
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-05
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
It has four individual software controlled set-points which can be set as a high or low limit. Any setpoint can be programmed to operate one of two output relays.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 56 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

Meter
Manufacturer:
Thornton
TT-625/626
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-01
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 57 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-623/624
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-01
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________Date: ____________________

Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 58 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-683/695
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-01
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 59 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-699/700
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-01
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 60 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-111 / TT-105 / FT-106
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-08
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
It has four individual software controlled set-points which can be set as a high or low limit. Any setpoint can be programmed to operate one of two output relays. It has temperature compensation with
automatic reference to 25 C conductivity.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 61 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-531 / TT-532 / FT-530
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-08,
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 62 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-645/665
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 63 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Conductivity Meter
Manufacturer:
Thornton
CIT-621 / TT-622
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 64 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-649 / TT-651 / FT-650
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 65 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-674 / TT-672 / FT-673
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 66 of 211

Room: Powerhouse
documents..
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-661/662
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 67 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
Gateway #2, T-NET-2
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-06
NEMA Rating:
Not Specified
Not Specified

Instruction Manual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 68 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
Gateway #1, T-NET-1
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-02, Powerhouse
NEMA Rating:
Not Specified
Not Specified
770 Network Interface Instruction

Manual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 69 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

Meter
Manufacturer:
Thornton
TT-101
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 70 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

/ Level Meter
Manufacturer:
Thornton
TT-103 / LT-104
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 71 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:

/ Level Meter
Manufacturer:
Thornton
TT-115 / LT-116
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 72 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Process Controller / Conductivity

/ Flow Meter
Manufacturer:
Thornton
CIT-123 / TT-125 / FT-124
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 73 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Process Controller / Conductivity

/ Flow Meter
Manufacturer:
Thornton
CIT-128 / TT-130 / FT-129
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 74 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-144 / TT-145 / FT-133
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-04, Area 2
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 75 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Conductivity Meter
Manufacturer:
Thornton
CIT-131 / TT-132
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-04, Area 2
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 76 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-219/220
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 77 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-212/233
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 78 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-205 / TT-207 / FT-206
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 79 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
CIT-231 / TT-232 / FT-229
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 80 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-216
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 81 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-235
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 82 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Temperature Meter
Manufacturer:
Thornton
TT-226
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 83 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Manufacturer:
Thornton
Gateway #2, T-NET-1
Model No.:
770 PC
Serial No.:
Under front bezel
Location:
CP-TT-07
NEMA Rating:
Not Specified
Not Specified

Instruction Manual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 84 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 24 VDC
Manufacturer:
Acopian
P1
Model No.:
A24H1200
Serial No.:
Not Specified
Location:
CP-01
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
Located in Panel CP-01 Powerhouse.
This device powers discrete I/O circuits and the SMC Solenoid bank valves.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 85 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 30 VDC
Manufacturer:
Acopian
P2
Model No.:
A30MT210
Serial No.:
Not Specified
Location:
CP-01
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device powers Analog I/O circuits.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 86 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 24 VDC
Manufacturer:
Acopian
P3
Model No.:
A24MT210
Serial No.:
Not Specified
Location:
CP-01
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device powers the SMC Solenoid bank electronics.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 87 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Power Supply
Manufacturer:
Allen Bradley
None
Model No.:
1771-P7
Serial No.:
Not Specified
Location:
CP-01, Chassis 1
NEMA Rating:
Not Specified
Not Specified
Allen Bradley 1771-I/O Chassis Power supply product data

Pub. 1771-2.185
COMMENTS:
1
This device supplies the 1st Chassis.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 88 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Power Supply
Manufacturer:
Allen Bradley
None
Model No.:
1771-P7
Serial No.:
Not Specified
Location:
CP-01, Chassis 2
NEMA Rating:
Not Specified
Not Specified

Pub. 1771-2.185
COMMENTS:
1
This device supplies the 2nd Chassis.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 89 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Power Supply
Manufacturer:
Allen Bradley
None
Model No.:
1771-P7
Serial No.:
Not Specified
Location:
CP-01A, Chassis 3
NEMA Rating:
Not Specified
Not Specified

Pub. 1771-2.185
COMMENTS:
1
Located in Panel CP-01A .
This device supplies the 3rd Chassis.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 90 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Power Supply
Manufacturer:
Allen Bradley
None
Model No.:
1771-P7
Serial No.:
Not Specified
Location:
CP-01A, Chassis 4
NEMA Rating:
Not Specified
Not Specified

Pub. 1771-2.185
COMMENTS:
1
This device supplies the 4th Chassis.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 91 of 211

Room: Powerhouse
documents.
Specified
Actual
System Type:
Power Supply
Manufacturer:
Allen Bradley
None
Model No.:
1771-P7
Serial No.:
Not Specified
Location:
CP-01A, Chassis 5
NEMA Rating:
Not Specified
Not Specified

Pub. 1771-2.185
COMMENTS:
1
This device supplies the 5th Chassis.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 92 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 24 VDC
Manufacturer:
Acopian
P4
Model No.:
A24H1500
Serial No.:
Not Specified
Location:
CP-01A
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device supplies the discrete I/O and the SMC Solenoid bank valves
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 93 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 30 VDC
Manufacturer:
Acopian
P5
Model No.:
A30MT210
Serial No.:
Not Specified
Location:
CP-01A
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device supplies the Analog I/O.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 94 of 211

Room: Powerhouse
documents.
Specified
System Type:
Power Supply 24 VDC
Manufacturer:
Acopian
P6
Model No.:
A24MT210
Serial No.:
Not Specified
Location:
CP-01A
NEMA Rating:
Not Specified
Not Specified
Actual
COMMENTS:
1
This device powers the SMC Solenoid bank electronics.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 95 of 211

Room: Powerhouse
HARDWARE CONFIGURATION VERIFICATION - JUMPERS
Document any jumper configurations for each major component. Verify all configurations in
accordance with the reference document(s). If specifications are available document source
information.
Hardware
Specified
Controller Tag ID No.
Allen Bradley CPU Module PLC

5/40, 1785-L40BC
PLC CIP
Location
PLC chassis, left most slot, CP-01
Equipment Name
Jumper / Dip Switch

Configuration
SW1
Actual
See Below
Off
On
DH+ Address
SW2
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Off
On
Communication Mode
Comments:
Note: Processor is at DH+ address 24 and its communications mode should be set to RS-232.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 96 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual
Allen Bradley Analog Output

Module 1771-OFE
PLC CIP
Location
Rack 1, Group 4, CP-01
Equipment Name
Jumper / Dip Switch

Configuration
See Below
Last State Jumpers
1
Verify / Date
Comments:
Set for minimum output on rack fault.
Allen Bradley publication 1771-6.5.3.0
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 97 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual

Module 1771-OFE
PLC CIP
Location
Equipment Name
Jumper / Dip Switch

Configuration
See Below
Last State Jumpers
1
Verify / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 98 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual

Module 1771-OFE
PLC CIP
Location
Equipment Name
Jumper / Dip Switch

Configuration
See Below
Last State Jumpers
1
Verify / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 99 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual
Allen Bradley Analog Input Module

1771-IFE
PLC CIP
Location
Equipment Name
Jumper / Dip Switch

Configuration
Last State Jumpers
Channel 1
Channel 2
See Below
Verify / Date
1
3
Last State Jumpers

Channel 5
29
31
11
Channel 6
13
Channel 3
27
15
Verify / Date
33
35
37
Channel 7
39
17
41
19
43
Channel 4
21
Channel 8
45
23
25
47
49
Comments:
Allen Bradley publication 1771-6.5.90
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 100 of 211

Room: Powerhouse
information.
Hardware
Specified
Allen Bradley Remote I/O Adapter

1771-ASB
PLC CIP
Location
Rack 2, Left most slot, CP-01
Equipment Name
Jumper / Dip Switch

Configuration
SW1
Actual
See Below
Open/Off
Closed/On
1
SW2
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Open/Off
Closed/On
Comments:
Allen Bradley publication 1771-2.48
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 101 of 211

Room: Powerhouse
information.
Hardware
Specified

1771-ASB
Remote PLC
Location
Rack 4, Left most slot, CP-01
Equipment Name
Jumper / Dip Switch

Configuration
SW1
Actual
See Below
Open/Off
Closed/On
1
SW2
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Open/Off
Closed/On
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 102 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual

1771-IFE
Remote PLC
Location
Rack 5, Group 7, CP-01A
Equipment Name
Jumper / Dip Switch

Configuration
Last State Jumpers
Channel 1
Channel 2
See Below
Verify / Date
1
3
Last State Jumpers

Channel 5
29
31
11
Channel 6
13
Channel 3
27
15
Verify / Date
33
35
37
Channel 7
39
17
41
19
43
Channel 4
21
Channel 8
45
23
25
47
49
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 103 of 211

Room: Powerhouse
information.
Hardware
Specified

1771-ASB
Remote PLC
Location
Rack 6, left most slot, CP-01A
Equipment Name
Jumper / Dip Switch

Configuration
SW1
Actual
See Below
Open/Off
Closed/On
1
SW2
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Open/Off
Closed/On
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 104 of 211

Room: Powerhouse
information.
Hardware
Specified
Actual

1771-IFE
Remote PLC
Location
Rack 7, Group 7, CP-01A
Equipment Name
Jumper / Dip Switch

Configuration
Last State Jumpers
Channel 1
Channel 2
See Below
Verify / Date
1
3
Last State Jumpers

Channel 5
29
31
11
Channel 6
13
Channel 3
27
15
Verify / Date
33
35
37
Channel 7
39
17
41
19
43
Channel 4
21
Channel 8
45
23
25
47
49
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 105 of 211

Room: Powerhouse
information.
Hardware
Specified

1771-ASB
Remote PLC
Location
Rack 10, left most slot, CP-01A
Equipment Name
Jumper / Dip Switch

Configuration
SW1
Actual
See Below
Open/Off
Closed/On
1
SW2
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Open/Off
Closed/On
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 106 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 12, Group 0
Location
Area CP-5-010
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 107 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 12, Group 4
Location
Area Interstitial, CP-5-08
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 108 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 12, Group 6
Location
Area Interstitial, CP-5-08
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 109 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 13, Group 0
Location
Area 103C, CP-5-02
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 110 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 13, Group 2
Location
Area CP-5-02
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 111 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 13, Group 4
Location
Area CP-5-01
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 112 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 13, Group 6
Location
Area CP-5-01
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 113 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 14, Group 0
Location
Area CP-5-05
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 114 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 14, Group 2
Location
Area CP-5-05
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 115 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 14, Group 4
Location
Area CP-5-06
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 116 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 14, Group 6
Location
Area CP-5-07
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 117 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 15, Group 0
Location
Area CP-5-03
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 118 of 211

Room: Powerhouse
information.
Hardware
Specified
Equipment Name
SMC Solenoid Bank
Rack 15, Group 2
Location
Area CP-5-04
Jumper / Dip Switch

Configuration
Address SW
Actual
See Below
Off
On
1
2 3 4 5 6
7 8 9 10
2 3 4 5 6
7 8 9 10
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 119 of 211

Room: Powerhouse
INPUT/OUTPUT LIST AND POINTS VERIFICATION
I/O Module Type/Model No.: Allen Bradley PLC 5
I/O Module Description: Analog and Discrete Modules
I/O Module Location: Racks 0 Verify the following list of Input/Output signals to/from the control system by simulating and
verifying I/O signals. Describe the test method below. Note: Points denoted as Spare will be
verified to be not connected to a field device and not included in the control logic.
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:020/00
I:020/00
FV-100 Valve Open Limit SW.
I:020/01
I:020/01
FV-100 Valve Closed Limit SW.
O:120/12
O:120/12
FV-100 Valve Command
I:020/02
I:020/02
I:020/03
I:020/03
O:120/13
O:120/13
I:020/12
I:020/12
I:020/13
I:020/13
O:120/17
O:120/17
I:021/02
I:021/02
I:021/03
I:021/03
O:122/12
O:122/12
I:021/04
I:021/04
I:021/05
I:021/05
O:122/14
O:122/14
TEST METHOD:
1
Inputs were examined using the PLC5 Programming Software online.
2
Outputs were verified using the PLC5 Programming Software online and Forcing the
respective output. The device operation was then verified in the field.
COMMENTS:
A
See attachment A CIP/SIP System I/O Checklist
B
The above points are a portion of a 20% recheck of Attachment A.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 120 of 211

Room: Powerhouse
I/O Module Location: Racks 0 - 16
Verify the following list of Input/Output signals to/from the control system by simulating and
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:021/10
I:021/10
I:021/11
I:021/11
O:124/00
O:124/00
I:021/12
I:021/12
I:021/13
I:021/13
O:124/01
O:124/01
I:021/14
I:021/14
I:021/15
I:021/15
O:124/02
O:124/02
I:021/16
I:021/16
I:021/17
I:021/17
O:124/03
O:124/03
I:022/00
I:022/00
I:124/01
I:124/01
O:122/04
O:122/04
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 121 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:022/02
I:022/02
I:022/03
I:022/03
O:124/05
O:124/05
I:022/04
I:022/04
I:022/05
I:022/05
O:124/06
O:124/06
I:022/06
I:022/06
I:022/07
I:022/07
O:124/07
O:124/07
I:022/10
I:022/10
I:022/11
I:022/11
O:124/08
O:124/08
I:022/12
I:022/12
I:022/13
I:022/13
O:124/11
O:124/11
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 122 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:023/04
I:023/04
I:023/05
I:023/05
O:124/16
O:124/16
I:023/06
I:023/06
I:023/07
I:023/07
O:124/17
O:124/17
I:023/10
I:023/10
I:023/11
I:023/11
O:126/04
O:126/04
I:023/12
I:023/12
I:023/13
I:023/13
O:126/02
O:126/02
I:023/14
I:023/14
I:023/15
I:023/15
O:126/00
O:126/00
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 123 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:043/14
I:043/14
I:043/15
I:043/15
O:130/00
O:130/00
I:043/16
I:043/16
I:043/17
I:043/17
O:130/01
O:130/01
I:044/00
I:044/00
I:044/01
I:044/01
O:130/02
O:130/02
I:044/02
I:044/02
I:044/03
I:044/03
O:130/03
O:130/03
I:044/04
I:044/04
I:044/05
I:044/05
O:130/04
O:130/04
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 124 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:044/06
I:044/06
I:044/07
I:044/07
O:130/05
O:130/05
I:044/10
I:044/10
I:044/11
I:044/11
O:130/15
O:130/15
I:044/12
I:044/12
I:044/13
I:044/13
O:134/00
O:134/00
I:044/14
I:044/14
I:044/15
I:044/15
O:130/06
O:130/06
I:044/16
I:044/16
I:044/17
I:044/17
O:130/07
O:130/07
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 125 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:045/00
I:045/00
I:045/01
I:045/01
O:130/10
O:130/10
I:045/02
I:045/02
I:045/03
I:045/03
O:130/11
O:130/11
I:045/04
I:045/04
I:045/05
I:045/05
O:130/12
O:130/12
I:045/06
I:045/06
I:045/07
I:045/07
O:130/13
O:130/13
I:045/10
I:045/10
I:045/11
I:045/11
O:130/14
O:130/14
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 126 of 211

Room: Powerhouse
Hardware
Point
Software
Address
Description
As
Specified
Yes / No
Verified
By / Date
I:046/00
I:046/00
I:046/01
I:046/01
O:150/13
O:150/13
I:046/02
I:046/02
I:046/03
I:046/03
O:150/12
O:150/12
I:046/04
I:046/04
I:046/05
I:046/05
O:134/04
O:134/04
I:046/06
I:046/06
I:046/07
I:046/07
O:134/05
O:134/05
I:046/10
I:046/10
I:046/11
I:046/11
O:130/16
O:130/16
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 127 of 211

Room: Powerhouse
Hardware
Point
Software
Address
O:015:00
O:015:01
O:015:02
O:015:03
O:016:00
O:016:01
N12:235
N12:236
N12:237
N12:238
N12:205
N12:206
O:016:02
N12:207
Description
As
Specified
Yes / No
Verified
By / Date
Pump CIP-6 Speed Signal

NPW Valve Position Command
HE-1 Temp. Control Valve
CIP Tank 1 Temp. Control
Valve
CIP Tank 2 Temp. Control
Valve
Tank P16 Weight
Tank P17 Weight
TT-NPW Temperature
O:016:03
N12:208
I:017:00
N12:39
I:017:01
N12:40
I:017:02
N12:41
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 128 of 211

Room: Powerhouse
Hardware
Point
Software
Address
I:057:00
I:057:01
I:057:02
I:057:03
I:057:04
I:057:05
I:057:06
I:077:00
I:077:01
I:077:02
I:077:03
N12:89
N12:90
N12:91
N12:92
N12:93
N12:94
N12:95
N12:139
N12:140
N12:141
N12:142
Description
WIT-660
WIT-690
WIT-691
WIT-692
WIT-697
WIT-411
WIT-696
WIT-052
WIT-054
WIT-058
WIT-412
As
Specified
Yes / No
Verified
By / Date
Weight
Weight
Weight
Weight
Weight
Weigh
Weight
Weight
Weight
Weight
Weight
TEST METHOD:
1
2
COMMENTS:
A
B
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 129 of 211

Room: Powerhouse
MAJOR HARDWARE COMPONENT VERIFICATION
Verify that major hardware components and computer related devices, such as control
panel, panel mounted devices, process I/O hardware, PLC, MMI, PC, printers,
communication Interface devices, etc., are installed in accordance with design specification
or vendor documents. Wiring will also be verified using the 20%/40%/100% option as
indicated by validation effort.
Item
No.
Hardware
Description
Manufacturer
Model No.
Serial
No.
Location
Verified
by/Date
Main PLC
enclosure
Remote PLC
enclosure
Kaye enclosure
Kaye enclosure
Kaye enclosure
CIP room
1
1
2
2
Comments:
1 See PRO-563-CQ Ancillary System Specification Verification section for specific information
on major components.
2 See IQ Controls Corporation As -Built drawings in Attachment D.
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 130 of 211

Room: Powerhouse
UTILITIES-ELECTRICAL
Confirm that the utilities necessary for the operation of the components of the control system have
been installed in accordance with design and/or manufacturing specifications.
Component Name:
Allen Bradley PLC Power Supply #1
PLC CIP
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
User Current Capacity
16 Amps
Line Power
Not Specified
Frequency
60 Hertz 1
Circuit Breaker Number
CB-2
Circuit Breaker Location
CP-01, TB1
Actual
COMMENTS:
1
Located in Panel CP-01, Powerhouse.
REFERENCE DOCUMENT(S):
Allen Bradley I/O Chassis and Power Supplies Product Data Pub #1771-2.185
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 131 of 211

Room: Powerhouse
Component Name:
PLC CIP
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
16 Amps
Line Power
Not Specified
Frequency
60 Hertz 1
CB-3
CP-01, TB1
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 132 of 211

Room: Powerhouse
Component Name:
Allen Bradley Panelview
Main OCS
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Frequency
60 Hertz 1
CB-4
CP-01, TB1
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 133 of 211

Room: Powerhouse
Component Name:
Acopian 24 DC Power Supply
P1
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
15 Amps
Line Power
1200 W
Frequency
60 Hertz 1
CB-6
CP-01, TB1
Actual
COMMENTS:
1
This supplies the Discrete I/O and the SMC solenoid bank valves.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 134 of 211

Room: Powerhouse
Component Name:
Acopian 30 VDC Power Supply
P2
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
2 Amps
Line Power
210 W
Frequency
60 Hertz 1
CB-5
CP-01, TB1
Actual
COMMENTS:
1
2
This supplies the Analog I/O.

Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 135 of 211

Room: Powerhouse
Component Name:
P3
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
2 Amps
Line Power
210 W
Frequency
60 Hertz 1
CB-7
CP-01, TB1
Actual
COMMENTS:
1
2
This unit supplies the SMC solenoid bank electronics.

Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 136 of 211

Room: Powerhouse
Component Name:
Remote Rack
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
16 Amps
Line Power
Not Specified
Frequency
60 Hertz 1
CB-2
CP-01A, TB1
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 137 of 211

Room: Powerhouse
Component Name:
Remote Rack
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
16 Amps
Line Power
Not Specified
Frequency
60 Hertz 1
CB-3
CP-01A, TB1
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 138 of 211

Room: Powerhouse
Component Name:
PLC CIP
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
16 Amps
Line Power
Not Specified
Frequency
60 Hertz 1
CB-4
CP-01A, TB1
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 139 of 211

Room: Powerhouse
Component Name:
P4
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
15 Amps
Line Power
1500 W
Frequency
60 Hertz 1
CB-6
CP-01A, TB1
Actual
COMMENTS:
1
This supplies the Discrete I/O and the SMC solenoid bank valves.
Located in Panel CP-01 .
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 140 of 211

Room: Powerhouse
Component Name:
P5
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
2 Amps
Line Power
210 W
Frequency
60 Hertz 1
CB-5
CP-01A, TB1
Actual
COMMENTS:
1
This supplies the Analog I/O.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 141 of 211

Room: Powerhouse
Component Name:
P6
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
2 Amps
Line Power
210 W
Frequency
60 Hertz 1
CB-7
CP-01A, TB1
Actual
COMMENTS:
1
This supplies the SMC solenoid bank electronics.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 142 of 211

Room: Powerhouse
Component Name:
Kaye Digistrip 4S-Plus Microprocessor Recorder
CP-02
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
CB-2
CP-02
Actual
COMMENTS:
1
Located in Area 1.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 143 of 211

Room: Powerhouse
Component Name:
CP-05
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
CB-2
CP-05
Actual
COMMENTS:
1
Located in Area 1036.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 144 of 211

Room: Powerhouse
Component Name:
CP-22
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
CB-2
CP-22
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 145 of 211

Room: Powerhouse
Component Name:
Nematron Operator Terminal
Remote OCS CP-07

Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
EDP2-2 #7
Interstitial Above 1089
Actual
COMMENTS:
1
Located in Area 2.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 146 of 211

Room: Powerhouse
Component Name:
Remote OCS CP-04

Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
ERP2-1B #15
Interstitial Northeast
Actual
COMMENTS:
1
Located in .
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 147 of 211

Room: Powerhouse
Component Name:
Remote OCS CP-TT-07

Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
ERP2-1B #16
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 148 of 211

Room: Powerhouse
Component Name:
Remote OCS CP-03

Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
ERP2-1B #13
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 149 of 211

Room: Powerhouse
Component Name:
Remote OCS
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
CB-3
CP-02
Actual
COMMENTS:
1
Located in Area 1.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 150 of 211

Room: Powerhouse
Component Name:
Nematron Operators Terminal
CP-05
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
CB-3
CP-05
Actual
COMMENTS:
1
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 151 of 211

Room: Powerhouse
Component Name:
Nematron Operators Terminal
CP-07
Specified1
Electrical System
Line Voltage
120 VAC 10%
Phase
Single Phase
Line Power
Not Specified
Frequency
60 Hertz 1
Actual

COMMENTS:
1
Located in Lyo Mechanical Area 2.
Verified By: __________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 152 of 211

Room: Powerhouse
SUPPLY VOLTAGE AND CIRCUIT PROTECTION VERIFICATION
Verify that the supply voltage to the control system is installed in accordance with the
manufacturers specifications. Record the location of voltage measurement and the actual
value.
Page 1 of 2
COMPONENT SUPPLY VOLTAGE
Location of
Voltage
Measurement
Specified
Result
Panelview Main
OCS
CP-01
120 VAC
Nematron
Operator
Terminal
CP-02
Nematron
Operator
Terminal
CP-03
Nematron
Operator
Terminal
CP-04
Nematron
Operator
Terminal
CP-05
Device Name
Actual
Result
Performed By /
Date:
+/- 10%
120 VAC
+/- 10%
120 VAC
+/- 10%
120 VAC
+/- 10%
120 VAC
+/- 10%
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 153 of 211

Room: Powerhouse
SUPPLY VOLTAGE AND CIRCUIT PROTECTION VERIFICATION
Verify that the supply voltage and circuit protection devices associated with the control
system are installed in accordance with the manufacturer specifications. Verify the
amperage and/or voltage of the protection device.
Page 2 of 2
COMPONENT SUPPLY VOLTAGE
Location of
Voltage
Measurement
Specified
Result
Nematron
Operator
Terminal
CP-TT-07
Suite 300
120 VAC
Nematron
Operator
Terminal
CP-07
Suite 400
120 VAC
Main PLC
enclosure CP-01
CP-01
Powerhouse
120 VAC
Remote PLC
enclosure
CP-01A
CP-01A
Suite 400
120 VAC
Device Name
Actual
Result
Performed By /
Date:
+/- 10%
+/- 10%
+/- 10%
+/- 10%
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 154 of 211

Room: Powerhouse
SOFTWARE COMPONENT VERIFICATION
Verify the following information about the installed software and source code for the specified
equipment. Document and comment on any noticeable deviations.
Equipment Name/Description:
Equipment ID No.:
Item
Kaye Validator
Digistrip 4 Plus , CP-02
Specified
Title
Validator Programmer
Software
Version
Not Specified
Date:
Not Specified
Location
Not Specified
Filename
Not Specified
Development
Software Used
Not Specified
Disk Copy
Installed Copy
Does the Installed Version Identification Disk Version Identification = Hardcopy Version
Identification?
YES / NO
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 155 of 211

Room: Powerhouse
SOFTWARE APPLICATION CODE VERIFICATION
ID No.: Control Coprocessor CP-01
Verify the current software source code and the internal change control procedure by contacting the
appropriate person. Ensure the current software is installed and implemented win accordance with the
applicable specifications. Obtain a printout of a program listing and/or batch files for comparison as
required.
Department contacted for Information on Application Source Code:
Name
Engineering Department
Company
Big Pharma
Software Source Code:

Manufacturer/Company Name
IQ Controls Corporation
Version/Date
March 27, 1996
Storage Location
Maintenance, Validation Files
Internal Change Control Procedure

Title/Name
Authorization SOP
Number
Version/Date
Storage Location
COMMENTS:
Verified By: ____________________________________________
Date: _____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 156 of 211

Room: Powerhouse
SOFTWARE APPLICATION CODE VERIFICATION
ID No.: Main OCS
Verify the current software source code and the internal change control procedure by contacting the
appropriate person. Ensure the current software is installed and implemented win accordance with the
applicable specifications. Obtain a printout of a program listing and/or batch files for comparison as
required.
Department contacted for Information on Application Source Code:
Name
Engineering Department
Company
Big Pharma
Software Source Code:

Manufacturer/Company Name
IQ Controls Corporation
Version/Date
October 29, 1996
Storage Location
Maintenance, Validation Files
Internal Change Control Procedure

Title/Name
Authorization SOP
Number
Version/Date
Storage Location
COMMENTS:
Verified By: ____________________________________________
Date: _____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 157 of 211

Room: Powerhouse
SECURITY CODE TEST
Verify that the program security prevents unauthorized access to process screens and PID parameter
changes. Obtain the current password from Maintenance and record the current password in the
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
Approach Remote
Operator Station at
CP-02,
From CIP System Idle

screen, Press Menu
Select Start CIP
Password Required screen appears
Enter an invalid
password, press
Enter
Returns user to Menu screen
Select Start CIP
Enter a valid operator

password, press
Enter
None
Menu screen appears
Change Circuit screen appears
COMMENTS:
1
Steps 1-6 verify the basic, operator level, security. .
See IQ Controls Corporation CIP/SIP System, Editors Manual for instructions on how to change/add
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 158 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
Select a circuit, press

Enter
Change Wash Type screen appears
Choose Select
Options, press Enter

level password, press
Enter
Returns to Change Wash Type screen
10
Choose Select
11
Enter a valid
supervisory level
password, press
Enter
Select Mode Select Cycles screen

appears
12
Test is complete,
press Cancel three
times.
CIP System Idle screen appears
COMMENTS:
1
Steps 7-12 verify the basic, operator level, security. .
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 159 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
13
Approach Remote
Operator Station at
CP-03,
14

screen, Press Menu
15
Select Start CIP
16
Enter an invalid
password, press
Enter
17
Select Start CIP
18

password, press
Enter
None
Menu screen appears
COMMENTS:
1
Steps 13-18 verify the basic, operator level, security.
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 160 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
19

Enter
20
Choose Select
21

Enter
22
Choose Select
23
Enter a valid
supervisory level
password, press
Enter

appears
24
Test is complete,
press Cancel three
times.
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 161 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
25
Approach Remote
Operator Station at
CP-04, Suite 100
26

screen, Press Menu
27
Select Start CIP
28
Enter an invalid
password, press
Enter
29
Select Start CIP
30

password, press
Enter
None
Menu screen appears
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 162 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
31

Enter
32
Choose Select
33

Enter
34
Choose Select
35
Enter a valid
supervisory level
password, press
Enter

appears
36
Test is complete,
press Cancel three
times.
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 163 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
37
Approach Remote
Operator Station at
CP-05, Suite 200
38

screen, Press Menu
39
Select Start CIP
40
Enter an invalid
password, press
Enter
41
Select Start CIP
42

password, press
Enter
None
Menu screen appears
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 164 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
43

Enter
44
Choose Select
45

Enter
46
Choose Select
47
Enter a valid
supervisory level
password, press
Enter

appears
48
Test is complete,
press Cancel three
times.
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 165 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
49
Approach Remote
Operator Station at
CP-TT-07, Suite 300
50

screen, Press Menu
51
Select Start CIP
52
Enter an invalid
password, press
Enter
53
Select Start CIP
54

password, press
Enter
None
Menu screen appears
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 166 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
55

Enter
56
Choose Select
57

Enter
58
Choose Select
59
Enter a valid
supervisory level
password, press
Enter

appears
60
Test is complete,
press Cancel three
times.
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 167 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
61
Approach Remote
Operator Station at
CP-07, Suite 400
62

screen, Press Menu
63
Select Start CIP
64
Enter an invalid
password, press
Enter
65
Select Start CIP
66

password, press
Enter
None
Menu screen appears
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 168 of 211

Room: Powerhouse
SECURITY CODE TEST
comments section.
Step
No.
Test Procedure
Specified Result
Actual Result
67

Enter
68
Choose Select
69

Enter
70
Choose Select
71
Enter a valid
supervisory level
password, press
Enter

appears
72
Test is complete,
press Cancel three
times.
COMMENTS:
1
passwords.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 169 of 211

Room: Powerhouse
FUNCTIONAL TEST VERIFICATION
Verify system operation by following the steps and associated test procedures in order. Verify the
descriptions for each step and verify that the system operation is in accordance with the specified
result.
Step
No.
Test Procedure
Approach Remote
Operator Control
Station at CP-02,

screen, press Menu
Select Start CIP

password, press
Enter
Select
FTESTNCY.PIN,
press Enter
Select Standard CIP,

press Enter
Press Enter
Specified Result
Actual Result
None
Menu screen appears

Enter to confirm screen appears

FTESTNCY.PIN
Standard CIP
After a delay, Program is to Function
Test 1037 CIP/SIP message appears
Reference Document and No.: Inc. CIP/SIP System Functional Design Document.
COMMENTS:
Note: For Area 2, Freeze dryer only.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 170 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
Specified Result
Actual Result
Press Enter
After a delay, Connect a hose and man.

valve message appears
Press Enter
After a delay, Ensure Man. Valve closed

message appears
10
Press Enter
After a delay, Install hose on CIPS-2

message appears.
11
Press Enter
12
Press Menu
13
Select Change Mode
After a delay, FV-056 is open and

042>30 gpm
FT-
Menu choices screen appears

F1-Run F2-Hold On F3-Halt F4-Hold Off
screen appears
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 171 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
14
Select Hold Off
15
Press Cancel
Specified Result
Actual Result
FT-042 goes to zero and FV-056 closes

Screen displays:
Step-005
Time xx:xx
off
Mode-Hold off
Hold
16
Press Menu
17
Select Change Mode
18
Select Run
19
Press Cancel
Screen displays:
Step-005
Time xx:xx
Hold off
Mode-Run
The time displayed will be counting down.
20
Time displayed
reaches 00:00
Screen displays:
Step-006
Time xx:xx
Hold on
Mode-Run
Also: FV-056 is open, FT-042 > 30 gpm
Timer is counting down.
21
Press Menu
22
Select Change Mode
Menu Choices screen appears

screen appears
FT-042 > 30 gpm, FV-056 opens

screen appears
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 172 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
Specified Result
Actual Result
23
Select Hold on
24
Press Cancel
25
Press Menu
26
Select Change Mode
27
Select Run
28
Press Cancel
29
Timer = 00:00
Message Hold on/off are finished

Starting F4 tests
30
Press Enter
After delay, FV-056 open, FT-042 >30 gpm
Menu Choice screen appears

Screen displays:
Step-006
Time xx:xx
Hold on
Mode-Run
Timer is not counting down.
screen appears
After a delay, screen displays:
Step-007
Time xx:xx
Mode-Run
Timer is counting down
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 173 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
31
Press F4 key on
front of panel
32
Press Cancel
33
Select Cancel
Note: Mode=Hold off
Specified Result
Actual Result
FV-056 is closed, FT-042 = 0

screen appears
Screen displays:
Step-008
Mode-Hold off
Time xx::xx
34
Press Menu
35
Select Change mode
36
Select Run
37
Press Cancel
Note: Mode=Run
Screen displays:
Step-008
Mode-Run
38
Timer=00:00
After a delay, F4 Test finished message

displays
39
Press Enter
FV-056 opens, FT-042 > 30 gpm

Timer begins timing
40
Timer=00:00
FV-056 closes, FT-042 = 0

Time test done message appears

screen appears
FV-056 opens, FT-042 = > 30 gpm
Time xx::xx
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 174 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
Specified Result
Actual Result
41
Press Enter
Tanks begin filling
42
Timer=00:00
Press Enter to Start Temp. test appears
43
In Room 1038,
remove TT-043 probe
from piping and put in
cool water
44
Press Enter
45
Press Enter
46
Put TT-043 in hot

water
47
Press Enter
When TT-043 > 70 c, screen should

display Temp. test finished message
48
Press Enter
Tank will fill for next test message

appears
TT-043 < 70 c
Screen displays:
Step-013
Time xx::xx
Mode-Run
Timer is not timing.
Program does not advance.
Event error TT-043 too low displays
TT-043 > 70 c
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 175 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
Specified Result
Actual Result
49
Reinstall TT-043 into

pipe
50
Press Enter
Tank P3 begins filling. FV-056 opens.
51
Timer=00:00
Press enter to start flow test

Ensure man. Valve is closed message
displays
52
Press Enter
53
Press Enter
54
Open manual valve

Observe FT-042 climb
55
Press Enter
Message Flow test finished displays
56
Press Enter
Tank will fill message appears
57
Press Enter
Tank P3 begins filling
58
Timer=00:00
Start conductivity screen appears
Reference Document and No.:
Screen displays:
Step-017
Time xx::xx
Mode-Run
Event error FT-042 is too low displays
FT-042 > 5.0 gpm
CIP/SIP System Functional Design Document.
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 176 of 211

Room: Powerhouse
result.
Step
No.
Test Procedure
Specified Result
59
In room 1038, remove

CT-041 probe from
piping and put in high
conductivity solution.
CT-041 > 5.0 S
60
Press Enter
61
Press Enter
62
Put CT-041 back into

piping. Open manual
valve. Press Enter
63
Press Enter
Reference Document and No.:
Actual Result
Screen displays:
Step-021
Time xx::xx
Mode-Run
CIT-041 too high Event error displays
CT-041 begins to decrease. When CT-041
< 5.0 S, message Cond.test finished
appears
CIP/SIP System Functional Design Document.
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 177 of 211

Room: Powerhouse
ALARM VERIFICATION
Verify that all device alarms controlled by the application logic are identified correctly, function
properly, and respond in accordance with the manufacturers specifications.
Test Description
Verification will be completed by creating specific alarm conditions and verifying the correct alarm
output is energized. For each alarm, document the test procedure used to activate the alarm and
the logic response to the alarm (if applicable). Record verification of the alarm annunciation alarm
acknowledge, and alarm reset for each alarm condition.
Alarm
Test Procedure
Specified Result
CR-117
Not
verified
At MCC2-1, turn manual

selector switch for CIP-1
to on for 10 seconds
Panelview displays alarm.

CIP batch printer prints
alarm.
CR-118
Not
verified


alarm.
CR-119
Not
verified


alarm.
CR-120
Not
verified


alarm.
CR-037
Not
verified


alarm.
Actual Result
Verified
By / Date
COMMENTS:
1
MCC2-1 is on Powerhouse
MCC1-1 is on Interstitial southeast area
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 178 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
CR-652
Not
verified

selector switch for CIP10 to on for 10 seconds

alarm.
CR-533
Not
verified

selector switch for CIP11 to on for 10 seconds

alarm.
FV-001
Failed to
proof
Actuate valve open

limit switch while valve
output is not active.

alarm.
FV-002
Failed to
proof
Actuate valve close

output is not active. 1

alarm.
FV-003
Failed to
proof
Actuate valve close


alarm.
FV-004
Failed to
proof
Actuate valve close


alarm.
Actual Result
Verified
By / Date
COMMENTS:
1
N.O. valve
MCC1-1 is on Interstitial southeast area
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 179 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-005
Failed to
proof
Actuate valve open


alarm.
FV-006
Failed to
proof
Actuate valve open


alarm.
FV-007
Failed to
proof
Actuate valve open


alarm.
FV-008
Failed to
proof
Actuate valve open


alarm.
FV-009
Failed to
proof
Actuate valve open


alarm.
FV-010
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 180 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-011
Failed to
proof
Actuate valve open


alarm.
FV-012
Failed to
proof
Actuate valve open


alarm.
FV-013
Failed to
proof
Actuate valve open


alarm.
FV-014
Failed to
proof
Actuate valve open


alarm.
FV-015
Failed to
proof
Actuate valve open


alarm.
FV-016
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 181 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-017
Failed to
proof
Actuate valve open


alarm.
FV-018
Failed to
proof
Actuate valve close


alarm.
FV-019
Failed to
proof
Actuate valve close


alarm.
FV-020
Failed to
proof
Actuate valve open


alarm.
FV-021
Failed to
proof
Actuate valve close


alarm.
FV-022
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
1
N.O. valve
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 182 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-023
Failed to
proof
Actuate valve open


alarm.
FV-024
Failed to
proof
Actuate valve open


alarm.
FV-025
Failed to
proof
Actuate valve open


alarm.
FV-029
Failed to
proof
Actuate valve open


alarm.
FV-030
Failed to
proof
Actuate valve open


alarm.
FV-031
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 183 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-032
Failed to
proof
Actuate valve open


alarm.
FV-055
Failed to
proof
Actuate valve open


alarm.
FV-056
Failed to
proof
Actuate valve open


alarm.
FV-057
Failed to
proof
Actuate valve open


alarm.
FV-100
Failed to
proof
Actuate valve open


alarm.
FV-107
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 184 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-108
Failed to
proof
Actuate valve open


alarm.
FV-109
Failed to
proof
Actuate valve open


alarm.
FV-110
Failed to
proof
Actuate valve open


alarm.
FV-112
Failed to
proof
Actuate valve open


alarm.
FV-113
Failed to
proof
Actuate valve open


alarm.
FV-134
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 185 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-135
Failed to
proof
Actuate valve open


alarm.
FV-136
Failed to
proof
Actuate valve open


alarm.
FV-137
Failed to
proof
Actuate valve open


alarm.
FV-138
Failed to
proof
Actuate valve open


alarm.
FV-139
Failed to
proof
Actuate valve open


alarm.
FV-140
Failed to
proof
Actuate valve open


alarm.
Actual Result
Verified
By / Date
COMMENTS:
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 186 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
FV-690
Failed to
proof
Actuate valve open


alarm.
FV-691
Failed to
proof
Actuate valve open


alarm.
Problem
reading
diskette
With no disk in
coprocessor, press
upload on panelview
supervisor screen
Panelview displays alarm..
SV-028
Failed to
proof
Actuate valve open

SV-230
Failed to
proof
Actuate valve open

Actual Result
Verified
By / Date
COMMENTS:
1
All alarms are time and date stamped.
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 187 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
Thornton
Gateway
1:128
failed
Disconnect TNET-01-01
from coprocessor
stopping communication
with Gateway 1:128

Batch printer prints alarm.
Thornton
Gateway
1:129
failed
from coprocessor
with Gateway 1:129

Thornton
Network
#1 failed
Disconnect both TNET01 cables from

coprocessor

Robertshaw DMS receives
CIP alarm.
Thornton
Gateway
2:128
failed
from coprocessor
with Gateway 2:128

Thornton
Gateway
2:129
failed
Disconnect RS-232EX
from coprocessor
with Gateway 2:129

Thornton
Network
#2 failed
Disconnect both cables

for Gateway 2:128 and
2:129 from coprocessor

Robertshaw DMS receives
CIP alarm.
Actual Result
Verified
By / Date
COMMENTS:
1
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 188 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
Thornton
xmtter
1:21
failed
Disconnect TNET wire

from each particular
transmitter

Thornton
xmtter
1:22
failed

transmitter

Thornton
xmitter
1:23
failed

transmitter

Thornton
xmitter
1:31
failed

transmitter

Thornton
xmitter
1:32
failed

transmitter

Thornton
xmitter
1:41
failed

transmitter

Actual Result
Verified
By / Date
COMMENTS:
1
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 189 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
Thornton
xmtter
1:42
failed

transmitter

Thornton
xmtter
1:71
failed

transmitter

Thornton
xmitter
1:72
failed

transmitter

Thornton
xmitter
1:73
failed

transmitter

Thornton
xmitter
1:74
failed

transmitter

Thornton
xmitter
1:75
failed

transmitter

Actual Result
Verified
By / Date
COMMENTS:
1
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 190 of 211

Room: Powerhouse
ALARM VERIFICATION
Test Description
Alarm
Test Procedure
Specified Result
A remote
OCS failed
to respond
While running cycle,

disconnect power from
remote OCS

Main seq
exceeded
max time
in step

remote OCS

Lyo seq
exceeded
max time
in step

remote OCS

General
PLC rack
failure
In CP-01 turn off rack 2

power supply

Robertshaw DMS
receives CIP alarm
SMC
solenoid
bank rack
failure
In any CP-S panel

remove power from
SMC valve solenoid
bank

Panelview
has rack
faulted
Disconnect Blue hose

remote I/O cable to CIP
panelview

Robertshaw DMS
receives CIP alarm
Actual Result
Verified
By / Date
COMMENTS:
1
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 191 of 211

Room: Powerhouse
POWER FAILURE TEST
Verify that each specified operation of the operator display panel accuracy performs the specified
function in accordance with the manufacturer specifications.
Step No.
Test Method
Specified Results
In Area 1 at CP-02 start

FTESTCY.PIN program.
When it is running, go to
Panel CP-01 in Powerhouse
and open circuit breakers
CB-2, CB-3. This powers off
the PLC.
In Area 1 at CP-02 start

FTESTCY.PIN program.
When it is running open
panel CP-02 and open circuit
breaker CB-3 removing
power from remote operator
control station.
Removes power from the

PLC, all devices are in failsafe mode. When power is
restored, the PLC restarts
the program safely or
returns to an initial
condition may restart the
operation.
During the power failure to
the operator display panel,
all devices are in a fail safe
mode. When power is
restored, the operator
display panel restarts
normally and returns to an
initial condition where the
operator may restart the
operation.
Actual Results
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 192 of 211

Room: Powerhouse
POWER FAILURE TEST
Verify that each specified operation of the operator display panel accuracy performs the specified
function in accordance with the manufacturer specifications.
Step No.
Test Method
Specified Results
With program
FTESTLYO.PIN running at
CP-07 in Area 2, go to CP-01
on Powerhouse and remove
power from control
coprocessor only.
With program
FTESTLYO.PIN running at
CP-07 in Area 1, go to CP-01
on Powerhouse and open
circuit breaker CB-4
Removes power to the

coprocessor all devices are
in fail-safe mode. When
power is restored, the
coprocessor restarts the
program safely or returns to
an initial condition may
restart the operation.
During the power failure to
the operator display panel,
all devices are in a fail safe
mode. When power is
restored, the operator
display panel restarts
normally and returns to an
initial condition where the
operator may restart the
operation.
Actual Results
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 193 of 211

Room: Powerhouse
ENVIRONMENTAL OPERATING PARAMETERS VERIFICATION
Verify that the environmental parameters (such as temperatures and relative humidity) within the
panels and/or cabinets where the controllers reside, are within the manufacturers specifications.
Temperature
Location
Controller
Internal to CP-01
Powerhouse
Allen-Bradley
PLC 5
Internal to CP-01
Powerhouse
Allen-Bradley
Panelview
CP-02 Area 1
Kaye printer/
recorder
CP-05 Area 2
Kaye printer/
recorder
Specified
0-60
degrees
Celsius
0-50
degrees
Celsius
0-50
degrees
Celsius
0-40
degrees
Celsius
Relative Humidity
Actual
Specified
Actual
Verified
By/Date
5-95% w/o
condensing
95% @ 0-30 C
75% @ 30-40 C
40% @ 40-50 C
95% noncondensing
90% RH or less
w/o
condensing
COMMENTS:
Reference documents: Allen-Bradley Publications 1784-1.10, dated May 1991; Allen-Bradley
Publication 2711.1.1, dated September 1992.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 194 of 211

Room: Powerhouse
ENVIRONMENTAL OPERATING PARAMETERS VERIFICATION
Verify that the environmental parameters (such as temperatures and relative humidity) within the
panels and/or cabinets where the controllers reside, are within the manufacturers specifications.
Temperature
Location
Controller
Internal to CP-22
Powerhouse
Kaye Printer
Recorder
Internal to
CP-01A
Area 3
1771-ASB
Remote I/O
Adapter
Specified
0-60
degrees
Celsius
0-50
degrees
Celsius
Relative Humidity
Actual
Specified
Actual
Verified
By/Date
5-95% w/o
condensing
95% @ 0-30 C
75% @ 30-40 C
40% @ 40-50 C
COMMENTS:
Reference documents: Allen-Bradley Publications 1784-1.10, dated May 1991; Allen-Bradley
Publication 2711.1.1, dated September 1992.
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 195 of 211

Room: Powerhouse
TEST EQUIPMENT
List all testing equipment used during the Controller Qualification testing.
Test Equipment Type

Multimeter
Model No.
Variables
Measured
Serial No.
Digital Volt Meter
Voltage, Amps,
Resistance
Volts/Amperes
Temperature/RH Meter
Temperature/RH
Calibration
Exp. Date
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 196 of 211

Room: Powerhouse
DRAWINGS
List the reference drawings for the system.
Drawing No.
Drawing Title
Main PLC
Main PLC Enclosure Layout
Sheet 1 of 23
Main PLC
Main PLC Panel Layout
Sheet 2 of 23
Main PLC
I/O Chassis Detail Rack 0 & 1
Sheet 3 of 23
Main PLC
Sheet 4 of 23
Main PLC
Terminal Block Layout - Rail 1
Sheet 5 of 23
Main PLC
Terminal Block Layout - Rail 3
Sheet 6 of 23
Main PLC
Terminal Block Layout - Rail 2 & 4
Sheet 7 of 23
Main PLC
Power Distribution (Main) 120 VAC
Sheet 8 of 23
Main PLC
Power Distribution (Main) 24 VDC
Sheet 9 of 23
Main PLC
Sheet 10 of 23
Main PLC
Sheet 11 of 23
Main PLC
Main Enclosure Rack 1, Group 4
Sheet 12 of 23
Storage Location: Validation Files
Revision
No.
Date
Original
1/27/06
6/10/06
6/10/06
Original
1/27/06
2/10/06
Original
1/31/06
Original
1/31/06
Original
1/31/06
Original
1/27/06
2/10/06
2/10/06
2/10/06
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 197 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Drawing Title
Main PLC
Sheet 13 of 23
Main PLC
Sheet 14 of 23
Main PLC
Sheet 15 of 23
Main PLC
Sheet 16 of 23
Main PLC
Sheet 17 of 23
Main PLC
Sheet 18 of 23
Main PLC
Sheet 19 of 23
Main PLC
Sheet 20 of 23
Main PLC
Sheet 21 of 23
Main PLC
Sheet 22 of 23
Main PLC
Sheet 23 of 23
Revision
No.
Date
2/10/06
2/10/06
Original
1/27/06
6/14/06
6/14/06
6/14/06
6/14/06
6/14/06
2/10/06
6/14/06
2/10/06
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 198 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Drawing Title
Remote PLC
Remote PLC Enclosure Layout
Sheet 1 of 44
Remote PLC
Remote Panel Layout
Sheet 2 of 44
Remote PLC
Sheet 3 of 44
Remote PLC
Sheet 4 of 44
Remote PLC
Sheet 5 of 44
Remote PLC
Terminal Block Layout Rail 1
Sheet 6 of 44
Remote PLC
Sheet 7 of 44
Remote PLC
Terminal Block Layout Rail 2 & 4
Sheet 8 of 44
Remote PLC
Sheet 9 of 44
Remote PLC
Power Distribution (remote) 120 VAC
Sheet 10 of 44
Remote PLC
Power Distribution (remote) 24 VDC
Sheet 11 of 44
Remote PLC
Power Distribution (remote) 24 VDC
Sheet 12 of 44
Revision
No.
Date
Original
1/27/06
Original
6/14/06
Original
1/27/06
Original
1/27/06
Original
1/27/06
Original
1/31/06
Original
1/31/06
Original
1/31/06
Original
1/31/06
Original
1/27/06
Original
1/27/06
Original
1/27/06
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 199 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Drawing Title
Remote-N. DWG
Remote OCS Network Schematic
Architec.DWG
Revision
No.
Date
Original
6/18/06
Proposed CIP System Architecture
12/14/06
TNET2A.DWG
Thornton Transmitter T-NET-2
2/10/06
TNET1A.DWG
2/10/06
TNET2.DWG
Original
6/6/06
Original
5/23/06
Equip

Schematic
Schematic
Control Equipment Overview
Original
1/10/06
ABRemote
Allen Bradley Remote Link
Original
1/13/06
OCS-Remote
Remote OCS Network
6/10/06
Original
1/31/06
Original
1/31/06
Original
1/31/06
TNET1.DWG
Non Kaye Sheet Kaye Enclosure

1 of 5
Non Kaye Sheet Terminal Block Layout CP-02
2 of 5
Non Kaye Sheet Kaye Power Distribution
3 of 5
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 200 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Non Kaye Sheet
4 of 5
Non Kaye Sheet
5 of 5
Kaye Sheet 1
of 6
Kaye Sheet 2
of 6
Kaye Sheet 3
of 6
Kaye Sheet 4
of 6
Kaye Sheet 5
of 6
Kaye Sheet 6
of 6
Kaye Sheet 6A
of 6
Drawing Title
Kaye Panel CP-02 Scanner 1
Electrical Dwg
Electrical Dwg
Kaye Enclosure Mfg
Revision
No.
Date
2/10/06
2/10/06
Original
1/31/06
Terminal Block Layout CP-05
Original
1/31/06
Kaye Power Mfg
Original
1/31/06
Scanner 1 Electrical drawing
2/10/06
2/10/06
2/10/06
2/10/06
Verified
By / Date

Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 201 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
CIP Kaye
Sheet 1 of 7
CIP Kaye
Sheet 2 of 7
CIP Kaye
Sheet 3 of 7
CIP Kaye
Sheet 4 of 7
CIP Kaye
Sheet 5 of 7
CIP Kaye
Sheet 6 of 7
CIP Kaye
Sheet 7 of 7
Drawing Title
Revision
No.
Date
Kaye Enclosure CIP Alarm
Original
1/31/06
Terminal Block Layout CP-22
Original
1/31/06
Kaye Power Distribution CIP Room
Original
1/31/06

Electrical Dwg
Kaye Panel Filler Scanner 1
Electrical Dwg
Kaye Panel Filler Scanner 2
Electrical Dwg
Kaye Panel Lyo Scanner 3
Electrical Dwg
Original
1/31/06
Original
2/10/06
Original
2/10/06
Original
2/10/06
Verified
By / Date

Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 202 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Drawing Title
Revision
No.
Loop Diagrams
Loop Diagram TT-034
Sheet 1 of 68
Loop Diagrams
Loop Diagram TT-035
Sheet 2 of 68
Loop Diagrams
Loop Diagram TT-036
Sheet 3 of 68
Loop diagrams
Loop Diagram TT-040/CIT-038
Sheet 4 of 68
Loop Diagrams
Loop Diagram FT-039
Sheet 5 of 68
Loop Diagrams
Loop Diagram FT-042
Sheet 6 of 68
Loop Diagrams
Loop Diagram TT-044
Sheet 7 of 68
Loop Diagrams
Loop Diagram TT-045
Sheet 8 of 68
Loop Diagrams
Loop Diagram TT-046
Sheet 9 of 68
Loop Diagrams
Sheet 10 of 68
Loop Diagrams
Sheet 11 of 68
Loop Diagrams
Loop Diagram TT-101
Sheet 12 of 68
Date
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 203 of 211

Room: Powerhouse
DRAWINGS
Drawing No.
Drawing Title
Revision
No.
Loop Diagrams
Loop Diagram TT-103
Sheet 13 of 68
Loop Diagrams
Loop Diagram TT-104
Sheet 14 of 68
Loop Diagrams
Sheet 15 of 68
Loop diagrams
Loop Diagram FT-106
Sheet 16 of 68
Loop Diagrams
Loop Diagram TT-115
Sheet 17 of 68
Loop Diagrams
Loop Diagram LT-116
Sheet 18 of 68
Loop Diagrams
Loop Diagram TT-124
Sheet 19 of 68
Loop Diagrams
Sheet 20 of 68
Loop Diagrams
Loop Diagram FT-129
Sheet 21 of 68
Loop Diagrams
Sheet 22 of 68
Loop Diagrams
Sheet 23 of 68
Loop Diagrams
Loop Diagram TT-133
Sheet 24 of 68
Date
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
2/22/06
Verified
By / Date
Comments:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 204 of 211

Room: Powerhouse
SPARE PARTS LIST
Manufacturer
Model Number
Description
Allen Bradley
1771-ASB
Allen Bradley
1771-IBD
Allen Bradley 24 VDC Discrete Input Module
Allen Bradley
1771-OBD
Allen Bradley 24 VDC Discrete Output Module
Allen Bradley
1771-IFE
Allen Bradley Analog 4-20 mA Input Module
Allen Bradley
1771-OFE
Allen Bradley Analog 4-20 mA Output Module
Allen Bradley
1771-L40B
Allen Bradley 5/40 Series B PLC CPU
Allen Bradley
1771-P7
Allen Bradley Chasis Mounted Power Supply
Allen Bradley
2711-KC1
Allen Bradley Panelview
SMC
IN313-AB1
SMC Solenoid Bank Serial Interface Unit
Nematron
IWS-120
Nematron Series 120 Industrial Terminal
Thornton
772-211
Thornton Instruments Smart Transmitter Series

770PC
Thornton
774-231
Thornton Instruments T-Net Lan Gateway for 770PCs
Thornton
1025-77
25 Thornton Sensors Patch Cord
Littlefuse
225-250
Littlefuse Type 2AG 1/4 A Fuses for Thornton
Black Box
RJ-ME790A-M
Black Box RS-232/422 Converter
Allen Bradley
1784-KT
Allen Bradley DH + Communications Card
Opto-22
AC24
Opto-22 RS-422 Computer Peripheral Adapter Card
Winncom
COMMENTS:
N.A.
Winncom Serial Port Expansion Card (4 ports)
Performed By: ____________________________________________

____________
SAMPLE
Date:
Page 205 of 211

Room: Powerhouse
Reviewed By: _______________________________________
__________________
Date:
MANUALS
List the reference manuals for the system.
Vendor
Advance Industrial
Systems
Advance Industrial
Systems
Advance Industrial
Systems
Advance Industrial
Systems
Allen-Bradley
Manual Title
Revision No.
CIP/SIP System Operators Manual
Original
CIP/SIP System Editors Manual
Original
CIP/SIP System Technicians Manual
Original
Original
Allen-Bradley
CIP/SIP System Functional Design

Document
Enhanced Ethernet PLC5 Programmable
Controller Users Manual
1771-IFE Analog Input Users Manual
Original
Allen-Bradley
1771-OFE Analog Output Users Manual
Original
Allen-Bradley
1771-IBD 10-30 VDC Input Module

Installation Book
1771-OBD Output Module Installation
Book
1771-ASB Remote I/O Adapter Users
Manual
Allen-Bradley
Allen-Bradley
Date
Verified
Original
1771-2.75
1771-2.76
1771-2.48
Storage Location:
COMMENTS:
Verified By: ___________________________________________
SAMPLE
Date: ____________________
Page 206 of 211

Room: Powerhouse
Reviewed By: __________________________________________
SAMPLE
Date: ____________________
Page 207 of 211

Room: Powerhouse
MANUALS
List the reference manuals for the system.
Vendor
Allen Bradley
Manual Title
Kaye
Panelview Operator Terminal Users

Manual
Series 110/120 Installation and Terminal
Guide
Kaye Digi 4S Plus Users Guide
Thornton
770 Network Interface Instruction Manual
Thornton
770 PC Process Controller Instruction

Manual
1771 I/O Chassis power supply product
data
Nematron
Allen Bradley
Revision No.
Date
Verified
2711-812
IWS-232
First Edition
Rev 1.0
Rev D
1771-2.185
Storage Location:
COMMENTS:
Verified By: ___________________________________________
Date: ____________________
Reviewed By: __________________________________________
Date: ____________________
SAMPLE
Page 208 of 211

Room: Powerhouse
STANDARD OPERATING PROCEDURES LIST
SOP #
REVISION
EFFECTIVE
DATE
TITLE
COMMENTS:
Performed By: ____________________________________________

_____________________
SAMPLE
Date:
Page 209 of 211

Room: Powerhouse
AMENDMENT(S) AND DEVIATION(S)
Any deviation that was determined during the execution of the CQ portion of this Protocol, must be
noted below.
Deviation No.:
AMENDMENT/DEVIATION:
Prepared By: ___________________________________________
Date: ____________________
Approved By: ___________________________________________ Date: ____________________
SAMPLE
Page 210 of 211

Room: Powerhouse
SUMMARY AND CONCLUSIONS

Summary
Verified By / Date
The system has been reviewed as outlined in the

Controller Qualification Section of this Protocol.
The requirements of the Controller Qualification Protocol
have been completed and appropriate data forms are
reviewed.
Comments, Amendments and Deviation, and special
notes related to the Controller Qualification of this
system/equipment have been reviewed and approved as
noted.
Conclusion
SAMPLE
Page 211 of 211

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BIG PHARMACEUTICALS, INC.

Protocol No.: SAMPLE

CONTROLLER QUALIFICATION PROTOCOL FOR

The attached protocol has been completed, the

BIG PHARMACEUTICALS, INC.

BIG PHARMACEUTICALS, INC.

The Validation Department has overall responsibility for the execution

The Maintenance/Engineering Manufacturing and QA Validation

The Manufacturing/Maintenance Department has responsibility for

The Validation Committee is responsible for the review of the

Engineering, validation and manufacturer's documents and drawings used to

BIG PHARMACEUTICALS, INC.

The control system contains three primary hardware subsystems:

Main Operator Control Station

Remote Operator Control Station

PLC 5/40 Programmable logic controller located in panel CP-01

Action Instruments control coprocessor. This industrial 386 PC

BIG PHARMACEUTICALS, INC.

An I/O Subsystem including:

Allen Bradley Digital Input/Output Modules

Allen Bradley Analog Input/Output Modules

SMC Solenoid Valve Banks: These are outputs on the

These devices are located throughout the plant.

CIP Batch Printer:

The Main Operator Control Station Subsystem is located in CP-01 on

The Remote Operator Control Station Subsystem consists of four

The Remote Operator Control Stations are the primary interface

BIG PHARMACEUTICALS, INC.

The specific requirements for the Controller Qualification are provided

The primary purpose of the Controller Qualification is to run the process

Testing performed by a third party approved by Big Pharma is

Proper completion and review of the Controller Qualification forms by a

CONTROLLER QUALIFICATION TEST METHODOLOGY: The installation

Controller Qualification Prerequisites

Purchase Order Inspection

Programmable Logic Controller Verification

Ancillary System Specification Verification

Hardware Configuration Verification -Jumpers

Input/Output List and Points Verification

Major Hardware Component Verification

BIG PHARMACEUTICALS, INC.

Supply Voltage and Circuit Protection Verification

Software Component Verification

Software Application Code Verification

Security Code Test

Functional Test Verification

Power Failure Test

Environmental Operating Parameters Verification

Spare Parts List

Standard Operating Procedures

Amendment(s) and Deviation(s)

Summary and Conclusions

BIG PHARMACEUTICALS, INC.

Verification that the controllers and components are appropriately identified

Verification that the supplied utilities meet the vendors specified

Verification that the program security functions as specified by the vendor.

BIG PHARMACEUTICALS, INC.

Verification that the application code currently operating in the controller is

Draw ings and Manuals:

Verification that current drawings and applicable manuals, such as vendor

Verification that the control system operates as designed and in accordance

Alarm and Interlocks:

Verification that the environmental conditions for the control system